If you are a woman with diabetes, you must immediately inform your health care provider if you are planning a pregnancy. Pregnant women who have diabetes before pregnancy diabetes are considered high risk and must be carefully monitored throughout their pregnancy. This does not automatically mean that you are going to have problems, but early pregnancy is a critical time for fetal development as the heart, brain, kidneys, and lungs of the infant begin to form. Too much sugar in the blood during this time can cause birth defects. Below are the complications that can arise during pregnancy, and tips to avoid these risks.
Complications of Diabetes in Pregnancy
Some complications that diabetes can cause during pregnancy include:
- The woman is more likely to have a miscarriage and stillbirth.
- The baby is 2 to 4 times more likely to have a serious birth defect than other babies. Heart defects and neural tube defects are more common among babies born to women with diabetes.
- The baby is likely to be very large (10 pounds or more). This makes vaginal delivery more difficult and puts the baby at risk for injuries during birth.
Tip #1: Obtain Specialized Care
Your health care provider will likely recommend that you see specialists during your pregnancy. These experts can help you better manage your diabetes and any other complications.
Here are examples of such specialists:
- A perinatologist focuses on high-risk pregnancies.
- An endocrinologist concentrates on problems of the endocrine (hormone) system, including diabetes.
If you’re taking oral diabetes medications, your provider will switch you to insulin. Health providers don’t recommend diabetes pills because of possible risks of birth defects.
Some women become less responsive to insulin while pregnant. This is called insulin resistance. You may need to change the kind and amount of insulin you take.
You may need more insulin later in pregnancy than earlier in pregnancy. This could mean doubling, or even tripling, the amount you normally used.
Tip #2: Manage Blood Glucose Levels
Get your diabetes under control 3 to 6 months before trying to get pregnant. You should take a multivitamin with 400 micrograms of folic acid every day. Folic acid has been shown to help reduce the risk of birth defects.
With your health provider’s advice, add regular physical activity to your daily routine. Healthy pregnant women should get at least 2 1/2 hours of aerobic exercise every week. Thirty minutes of aerobic exercise on most, if not all, days will meet this requirement. Examples of aerobic exercise are walking, swimming, and dancing.
Tip #3: Seek Advice from a Dietician
Now is the time to see a dietician. A dietician is a specialist in nutrition and healthy eating. Your dietician can:
- Help you learn the kinds and amounts of food to eat and how often you should eat
- Help you understand servings and portion sizes of your meals
- Create a specialized meal plan according to your needs, likes, and dislikes
- Work with you to have healthy goals for your weight gain and blood glucose levels during pregnancy
Tip #4: Understand the Causes of Hypoglycemia and Hyperglycemia
Women with preexisting diabetes are at increased risk of having low blood glucose (or hypoglycemia) during pregnancy. When blood glucose levels are too low, your body can’t get the energy it needs. Usually, hypoglycemia is mild and can easily be treated by eating or drinking something with sugar. But, if left untreated, hypoglycemia can make you pass out. Low blood glucose can be caused by:
- Meals or snacks that are too small, delayed, or skipped
- Doses of insulin that are too high
- Increased activity or exercise
When your body doesn’t have enough insulin, or isn’t able to use insulin correctly, you could be at risk of having high blood glucose, also called hyperglycemia. This condition can be caused by:
- A mismatch between food and medication
- Eating the wrong kinds of foods
- Eating more food than usual
- Being less active than usual
Follow the above tips, and enjoy a pregnancy free of diabetic complications!